Culture Care Needs of Puerto Rican Women Receiving HIV Care from Nurse Practitioners in New York City

Abstract

The purpose of this mini-ethnonursing research study was to discover, describe, and interpret culture care values, beliefs, expressions, practices and needs of Puerto Rican women receiving HIV care from nurse practitioners (NPs) and other providers in New York City. The emic, or insider, perspective of Puerto Rican women living with HIV was the focus of this study and Leininger’s Culture Care Theory (CCT) provided the theoretical framework. Various enablers of the CCT, including Leininger’s Sunrise Enabler to Discover Culture Care, guided the design andimplementation of the study. Six key and twelve general informantswere interviewed and data from the interviews were coded using the QSR NVIVO10 software. Categories of data discovered through analysis included Puerto Rican female identity; self-care; caring for others; family and familismo; culture; personalismo and professional care; and, living with HIV. Other important data focused on experiences of various forms of discrimination; substance use; and, intimate partner violence. Sixteen patterns; and, five universal and one diverse theme emerged through analysis. Culture care decision and action modes were identified to assist providers to preserve and/or maintain, accommodate and/or negotiate, and repattern and/or restructure culture care practices, patterns, and experiences of Puerto Rican women receiving HIV care. Current HIV care practice emphasizes engaging patients in the HIV continuum of care and the culture care decision and action modes can enhance desired engagement. Implications for theory, research, practice, education, healthcare administration and healthcare policy were made based on the findings and analysis. These recommendations can improve delivery of care for diverse communities living with HIV